ATI RN
ATI Pediatric Proctored Exam 2023
1. A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?
- A. Spinal cord injury
- B. Increased intracranial pressure
- C. Typical for sleep
- D. Improvement
Correct answer: B
Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.
2. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?
- A. Measuring intake and output
- B. Inserting a Foley catheter
- C. Covering the defect with sterile plastic wrap
- D. Palpating the bladder mass to ensure urine is expelled
Correct answer: C
Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.
3. Why is the specific gravity for infants lower than for older children?
- A. Infants have a greater body surface area.
- B. Infants have a higher basal metabolic rate.
- C. Infants have a greater percentage of body weight that is water.
- D. Infants' kidneys are less able to concentrate urine.
Correct answer: D
Rationale: The correct answer is D because infants' kidneys are less developed compared to older children, making them less efficient at concentrating urine. This results in a lower specific gravity in infants. The other choices do not directly explain why the specific gravity is lower in infants.
4. A healthcare provider is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 101.2 degrees Fahrenheit. Available is ibuprofen liquid 100 mg/5 ml. How many milliliters should the healthcare provider administer to the infant?
- A. 12 ml
- B. 6 ml
- C. 2 ml
- D. 1 ml
Correct answer: C
Rationale: To calculate the correct dosage, first convert the infant's weight to kilograms: 17.6 lb = 8 kg. The prescribed dose is 5 mg/kg, so for an 8 kg infant, the total dose required is 40 mg. Since the available ibuprofen liquid is 100 mg/5 ml, to find out how many milliliters to administer, divide the total dose (40 mg) by the concentration of the liquid (100 mg/5 ml), which equals 2 ml. Therefore, the healthcare provider should administer 2 ml of ibuprofen to the infant.
5. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?
- A. HR of 60 bpm
- B. BP of 160/88
- C. Discolored urine
- D. Inspiratory wheezing
Correct answer: C
Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.
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